Vertigo and age: what changes?

In children and younger adults, vertigo may accompany migraine, an ear infection or a temporary inner-ear disturbance. In later life, benign paroxysmal positional vertigo becomes an important possibility, particularly when rolling over, looking up or getting out of bed brings brief spinning. Reduced vision, joint stiffness, nerve sensation changes and hearing loss can make recovery from an episode harder. Several medicines, including some used for blood pressure, sleep or anxiety, may contribute to unsteadiness or lightheadedness. Age alone does not identify the cause, and a new symptom should not be dismissed as normal ageing.

Pause before standing, use good lighting and keep a stable surface nearby. Remove loose rugs and avoid walking alone during an active episode. Keep a record of what happens before the spinning, how long it lasts, head positions, hearing symptoms and every medicine or supplement used. A clinician can check eye movements, walking, hearing, blood pressure and positional triggers. Do not stop prescribed medicines without advice. Treatment may involve a targeted repositioning manoeuvre when the findings fit that diagnosis.

Get urgent help for vertigo with sudden weakness, new confusion, trouble speaking, fainting, severe headache, chest pain, new double vision or an inability to walk. Seek prompt review after a fall or head injury, or for sudden hearing loss, persistent vomiting or a rapidly worsening episode. Older adults may need assessment sooner when balance changes create a fall risk, even without pain.

Ask which causes fit your age, symptom triggers and examination. Bring a current medicine list and mention falls, hearing changes, migraine features, recent illness and whether spinning occurs only with position changes. Ask what movement is safe while symptoms settle and whether a balance or hearing assessment would help.